Individual provider Active NPI

Robert S Glick, DPM

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1982742920
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016002695 Issued in IL
Practice address
1630 W 18TH St
Chicago, IL 60608-2817
Phone
(312) 243-3131
Fax
(312) 666-2289
NPI assigned
Feb 2, 2007
Last updated
Aug 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016002695 IL Primary

Addresses

Primary practice location

1630 W 18TH St
Chicago, IL 60608-2817

Mailing address

1630 W 18TH St
Chicago, IL 60608-2817
Phone (312) 243-3131

Other identifiers 1

IdentifierTypeStateIssuer
016002695MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000112 IL Practitioner - Podiatry 8224934336 Reassigns benefits to 3 organizations
Practice locations: Northbrook, IL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians
Il Foot and Ankle Clinic Medical CorpGroup PAC ID 8820183742, 6 clinicians

Practice addresses (Care Compare)

1601 N Western Ave
Park Ridge, IL 60068-1233
Phone (847) 825-5531

8937 W Golf Rd
Niles, IL 60714-5812
Phone (847) 833-1199

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue40
Removal of skin lesions21
Removal of nail tissue966
Removal or shaving of skin growth736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC CurrentSince Dec 1, 2023 Accepting new patients
Il Foot & Ankle Clinic Medical Corp Podiatrist CurrentSince Mar 1, 2014 Accepting new patients
Siloam Home and Wound Care Physicians Inc CurrentSince Feb 22, 2020 Accepting new patients
Housecall Professionals Inc PastSince Jul 1, 2017 Accepting new patients
Ideal Anesthesia Services PC Past Accepting new patients

Locations

3601 S Harlem Ave
Berwyn, IL 60402
Phone (708) 484-1486

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

1400 E Golf Rd
Ste 201
Des Plaines, IL 60016
Phone (847) 298-3338

8937 W Golf Rd
Niles, IL 60714
Phone (847) 375-9711

1601 N Western Ave
Park Ridge, IL 60068
Phone (773) 960-1163

3450 Oakton St
Ste 300
Skokie, IL 60076

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1982742920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 W 18TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082817",
            "telephone_number": "312-243-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 W 18TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082817",
            "telephone_number": "312-243-3131",
            "fax_number": "312-666-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016002695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016002695",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.